In the dystopian novel 1984, George Orwell introduced the idea that vocabulary has the power to control thought. In 1984, the government, in an effort to control citizens and force them into submission, perverts the meaning of common words and phrases to promote approved views and stamp out unapproved views. The classic example of this effort is the following quote:

War is peace.
Freedom is slavery.
Ignorance is strength.

This type of language manipulation is also known as “doublespeak,” which Wikipedia defines as:

… [L]anguage that deliberately disguises, distorts, or reverses the meaning of words. Doublespeak may take the form of euphemisms (e.g., “downsizing” for layoffs, “servicing the target” for bombing, making the truth less unpleasant, without denying its nature. It may also be deployed as intentional ambiguity, or reversal of meaning (for example, naming a state of war “peace”). In such cases, doublespeak disguises the nature of the truth, producing a communication bypass.

Natural childbirth advocacy relies to a large extent on doublespeak in its ongoing efforts to wrest legitimacy from modern obstetrics.

This reliance begins with its very name. The philosophy of “natural childbirth” has nothing to do with childbirth in nature. Indeed its creation was launched on an outright lie, the claim that “primitive” women did not feel pain in childbirth. The accoutrements of contemporary natural childbirth advocacy have nothing to do with nature either. Not only was were their no childbirth classes, nutrition counseling and birth affirmations in nature, there were also no bathtubs, birthing balls or hypnosis tapes. There’s precious little about natural childbirth that is natural.

The pattern of doublespeak has numerous analogues cheerfully bandied about by natural childbirth advocates.

For example:

1. Variation of normal actually means abnormal. Natural childbirth claims to concern itself exclusively with low risk, uncomplicated vaginal deliveries. Unfortunately, many births are complicated by minor, major or even life threatening abnormalities. That’s why childbirth has always been — in every time, place and culture, including our own — a leading cause of death of young women and the leading cause of death for babies.

Not to worry, though. Natural childbirth advocates have come up with a way to ignore that reality. They have simply labeled abnormal and high risk situations as “variations of normal.” For example, instead of acknowledging that breech, twins, VBAC and postdates — all of which are known to increase the risk of death for babies and mothers — are high risk, they simply pretend they are “variations” of low risk.

2. Evidence based means based on no evidence at all. Natural childbirth advocates are fond of describing natural childbirth as “evidenced based” and excoriating modern obstetrics as not based on scientific evidence. Let’s leave aside for the moment that most natural childbirth advocates have never read a scientific paper and wouldn’t understand it even if they did, it is indisputable that almost every practice exclusive to natural childbirth is based on no evidence whatsoever.

Consider the “best practices” recommended by Lamaze:

Let labor begin on its own: There is no scientific evidence that a spontaneous labor is better or safer for babies. Indeed, there is copious scientific evidence that the risk of stillbirth begins increasing before 38 weeks and rises steadily with each day that passes. That risk must, of course, be balanced against any risks of induction to the mother, but, even so, it is factually false to claim that spontaneous labor is safer. Indeed, as the rate of induction has risen in the US, the rate of late stillbirth has fallen dramatically.

Walk, move around and change positions throughout labor: There’s no scientific evidence that moving around or changing positions has any impact on labor, let alone a beneficial impact. According to the Cochrane review on position in labor, “There were no differences between groups for other outcomes including length of the second stage of labour, mode of delivery, or other outcomes related to the wellbeing of mothers and babies.”

Avoid interventions that are not medically necessary: In other words, refuse an epidural; yet there is no scientific evidence that childbirth without pain relief is better, safer, healthier or superior in any way to childbirth with pain relief.

Indeed, every single practice exclusive to natural childbirth advocacy was instituted before it was ever tested in clinical practice and, to this day, most of it is unsupported by scientific evidence.

3. Baby friendly and mother friendly means “bears no relationship to what the majority of women and babies need or want, but enhances the self-esteem of advocates.” From harassing women to breastfeed, to removing well baby nurseries, to grossly overstating risks of epidurals and grossly overstating benefits of refusing interventions, most practices promoted as either baby friendly or mother friendly confer little or no benefit and are the opposite of what women choose when their choices are taken into account.

Then there are the euphemisms:

4. Vocalized means screaming in agony.

5. Primal means screaming in agony.

6. Sensations means agony.

I could go on, but I think you get the idea. Natural childbirth advocacy is devoted to and relies on doublespeak for a great deal of its appeal. It sells itself as natural, but bears no relationship to childbirth in nature. It insists it is appropriate for only low risk birth, but then renames high risk situations as variations of normal. It claims to be based on scientific evidence, but generally has no scientific support at all. It claims to be baby and mother friendly, but very few women would choose to follow its recommendations without being shamed into it and there is no evidence that it is beneficial for babies. And the sheer number of euphemisms for agonizing pain make it very clear that there is considerable effort devoted to lying about the pain of childbirth.

I’ll leave you with a final quote from 1984:

Orthodoxy means not thinking–not needing to think. Orthodoxy is unconsciousness.

Natural childbirth advocacy is a form of orthodoxy that deliberately subverts language in an effort to conceal the reality of childbirth and promote a philosophy whose primary goal appears to be enhancing the self-esteem of its advocates at the expense of the majority of mothers and babies.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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